Africans unite across borders in massive effort to combat epidemic and get polio eradication effort back on track

8 OCTOBER 2004 | GENEVA -- More than one million polio vaccinators in 23 African countries today embark on a massive immunization campaign, aiming to immunize 80 million children across sub-Saharan Africa against polio over just four days. This effort is a direct response to an ongoing polio epidemic in the region, which risks paralysing thousands of children for life.

Tens of thousands of traditional and religious leaders, school teachers, parents and Rotary club members will join nurses and a vast array of other volunteers and health workers to systematically go house-to-house and village-to-village, to hand-deliver the vaccine to every child under the age of five years. To succeed, these vaccinators - many of them volunteers - will need to cover half of the African continent, an area larger than western Europe, on foot, horseback, bicycle, boat, car or whatever means possible.

Reaching every one of the 80 million children will present vaccinators with tremendous challenges. For up to 12 hours every day, many will battle stifling humidity, dusty environments, temperatures upward of 40 °C and in some places torrential downpours at the end of the rainy season. Every immunization team will carry iced vaccine carriers to maintain the polio vaccine until it is administered to a child. Collectively, more than 100 million doses of polio vaccine will be carried in the iced carriers, filled with well over three million ice-packs.

Civil unrest in a number of the participating countries will complicate access to children, particularly in parts of Côte d’Ivoire, Liberia and the Sudan. The recent spread of polio in the Darfur region of the Sudan and spread to Khartoum underscores the speed with which the virus can re-infect communities, particularly those which are displaced and isolated by conflict. In some areas, such as in parts of Liberia, the polio vaccine has to be airlifted to otherwise inaccessible parts of the country, putting a further strain on already stretched financial, human and technical resources.

Across Africa the communication challenges will match the logistical challenges. Once households are reached, many vaccinators will have to alleviate parents' concerns regarding the safety of the polio vaccine. Since mid-2003, unfounded rumours concerning vaccine safety, originating in northern Nigeria, have been circulating widely, leading to substantial confusion across the region, particularly in the poorest communities where access to basic healthcare is limited. To help reassure families, vaccinators have been trained on the importance of re-assuring parents that polio vaccination is safe and the only way to protect their children from life-long disability caused by the poliovirus.

The eradication effort has united all levels of civil society in Africa to collectively eradicate this disease. Traditional, community and religious leaders throughout the region have pledged their support. From the Emir of Kano and the Sultan of Sokoto in Nigeria, to traditional chiefs in Burkina Faso and surrounding countries - all have expressed their intention to engage their full constituencies to advocate for a polio-free Africa.

Smaller-scale activities held in 2000 and 2001 had previously stopped polio in all countries in the region, except Nigeria and Niger. In these two countries, immunization activities need to improve if polio is to be stopped in Africa by end-2005.

But if the campaigns reach enough children in the region's hotspots, polio transmission can be expected to slow significantly by the end of this year. In some countries where the virus has a weaker foothold, transmission could stop completely by early 2005, epidemiologists predict. The spearheading partners of the Global Polio Eradication Initiative - the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF - stress that the benefits of these campaigns must be underpinned by strong routine immunization services and prioritising healthcare to the poorest communities, to provide the best defence against the poliovirus.

This campaign was given a significant political boost on 2 October at an official presidential launch. H.E. Mr Olusegun Obasanjo, President of the Federal Republic of Nigeria and Chairperson of the African Union, Professor Alpha Oumar Konaré, Chairperson of the African Union Commission, and Jonathan Majiyagbe, past President of Rotary International and long-time resident of Kano, added their support at a launching celebration in Kano, Nigeria. As part of the proceedings, President Obasanjo personally immunized the daughter of the Governor of Kano.

A great deal is riding on the success of these campaigns, with a global investment of over US$ 3 billion since 1988 for the eradication effort, including more than US$ 500 million contributed by Rotary International. An additional US$ 200 million is required to implement similar cross-border polio immunization campaigns on 18 November and throughout 2005. If Africa can meet this challenge, it will boost confidence in other public health and development initiatives.

Notes to editors:

The ongoing polio outbreak originating in northern Nigeria occurred due to a combination of factors, including the suspension of polio campaigns in mid-2003 in Kano, Nigeria (due to unfounded concerns regarding the safety of the oral polio vaccine), and low routine immunization coverage in countries surrounding Nigeria. Polio campaigns resumed in Kano on 31 July 2004.

The 23 countries participating in the polio campaign are: Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Congo-Brazzaville, Côte d'Ivoire, the Democratic Republic of the Congo, Equatorial Guinea, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Nigeria, Niger, Senegal, Sierra Leone, Togo and Sudan. Start dates for each respective national campaign vary - 19 of the 23 countries' campaigns will be conducted in October.

The Global Polio Eradication Initiative is spearheaded by the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF. The poliovirus is now endemic in only six countries, down from over 125 when the Global Polio Eradication Initiative was launched in 1988.

The six remaining polio-endemic countries are: Nigeria, India, Pakistan, Niger, Afghanistan and Egypt. As at 6 October 2004, this year there have been 786 cases reported globally, in the following endemic countries: Nigeria (597 cases), India (62), Pakistan (31), Niger (20), Afghanistan (3), Egypt (1); and the following importation countries: Benin (6), Botswana (1), Burkina Faso (6), Cameroon (2), the Central African Republic (12), Chad (16), Côte d'Ivoire (15), Guinea (1), Mali (2) and the Sudan (11).

The polio eradication coalition includes governments of countries affected by polio; private sector foundations (e.g. United Nations Foundation, Bill & Melinda Gates Foundation); development banks (e.g. the World Bank); donor governments (e.g. Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Ireland, Italy, Japan, Luxembourg, the Netherlands, New Zealand, Norway, Portugal, the Russian Federation, Spain, the United Kingdom and the United States of America); the European Commission; humanitarian and nongovernmental organizations (e.g. the International Red Cross and Red Crescent societies) and corporate partners (e.g. Aventis Pasteur, De Beers, Wyeth). Volunteers in developing countries play the central role; 20 million have participated in mass immunization campaigns.

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